Reconstruction of a 10-cm Defect in the Distal Humerus Using a Lambda-Shaped Free Vascularized Fibular Flap: A Case Report.

CASE: A 48-year-old man with multiple injuries sustained a Gustilo type 3A right open distal humerus fracture with a 4-cm wound, contralateral radius shaft, and ilium fractures. Following wound irrigation on the day of injury, second look debridement showed crushed triceps and severe contamination extending into the distal humerus medullary canal. After 6 days of initial plate fixation, he developed signs of deep infection. Radical debridement twice resulted in a 10-cm bone defect, necessitating reconstruction with a Lambda-shaped free vascularized fibula for both columns.

CONCLUSION

Lambda-shaped column reconstruction using free vascularized fibula flap yields satisfactory clinical and radiographic outcomes in metaphyseal distal humerus bone defects.

LEVEL OF EVIDENCE: V.

LEVEL OF CLINICAL CARE: Level I Tertiary trauma center.